{"corpus_id":52181910,"paper_sha":"6cd24cd6d32a1f171442b203569c94dc49e2137c","doi":"10.1016/S2352-4642(18)30273-6","arxiv_id":null,"pmid":30201470,"pmcid":"PMC6196075","mag_id":3008094415,"dblp_id":null,"acl_id":null,"title":"Influence of maternal obesity on the association between common pregnancy complications and risk of childhood obesity: an individual participant data meta-analysis.","year":2018,"publication_date":"2018-07-01","venue":"The Lancet Child & Adolescent Health","journal":{"name":"The Lancet. Child & adolescent health","pages":"\n          812-821\n        ","volume":"2 11"},"journal_issn":null,"journal_title":null,"publication_types":["JournalArticle"],"pubmed_pub_types":["Journal Article","Meta-Analysis","Research Support, Non-U.S. Gov't"],"s2_fields_of_study":["Medicine"],"reference_count":53,"citation_count":100,"influential_citation_count":3,"is_open_access":true,"arxiv_categories":null,"arxiv_license":null,"arxiv_journal_ref":null,"mesh_headings":[{"d":"Adolescent","mj":false,"ui":"D000293"},{"d":"Animals","mj":false,"ui":"D000818"},{"d":"Body Mass Index","mj":false,"ui":"D015992"},{"d":"Child","mj":false,"ui":"D002648"},{"d":"Child, Preschool","mj":false,"ui":"D002675"},{"d":"Diabetes, Gestational","mj":true,"ui":"D016640"},{"d":"Europe","mj":false,"qs":[{"q":"epidemiology","mj":false,"ui":"Q000453"}],"ui":"D005060"},{"d":"Female","mj":false,"ui":"D005260"},{"d":"Humans","mj":false,"ui":"D006801"},{"d":"Hypertension, Pregnancy-Induced","mj":true,"ui":"D046110"},{"d":"Life Style","mj":false,"ui":"D008019"},{"d":"North America","mj":false,"qs":[{"q":"epidemiology","mj":false,"ui":"Q000453"}],"ui":"D009656"},{"d":"Obesity","mj":false,"qs":[{"q":"complications","mj":true,"ui":"Q000150"}],"ui":"D009765"},{"d":"Pediatric Obesity","mj":false,"qs":[{"q":"epidemiology","mj":true,"ui":"Q000453"},{"q":"prevention & control","mj":false,"ui":"Q000517"}],"ui":"D063766"},{"d":"Pre-Eclampsia","mj":true,"ui":"D011225"},{"d":"Pregnancy","mj":false,"ui":"D011247"},{"d":"Pregnancy Complications","mj":true,"ui":"D011248"},{"d":"Risk Factors","mj":false,"ui":"D012307"}],"chemicals":null,"comments_corrections":null,"source_flags":5,"s2_open_access_pdf_url":"https://cris.maastrichtuniversity.nl/files/81905286/Thijs_2018_Influence_of_maternal_obesity_on.pdf","s2_open_access_landing_url":"https://www.semanticscholar.org/paper/6cd24cd6d32a1f171442b203569c94dc49e2137c","s2_open_access_license":"other-oa","s2_open_access_status":"GREEN","pmc_open_access_pdf_url":null,"pmc_open_access_landing_url":null,"pmc_open_access_license":null,"pmc_open_access_status":null,"unpaywall_open_access_pdf_url":null,"unpaywall_open_access_landing_url":null,"unpaywall_open_access_license":null,"unpaywall_open_access_status":null,"abstract":"BACKGROUND\nGestational diabetes and gestational hypertensive disorders are associated with offspring obesity, but the role of maternal adiposity in these associations remains unclear. We aimed to investigate whether these pregnancy complications affect the odds of offspring obesity independently of maternal obesity.\n\n\nMETHODS\nWe did an individual participant data (IPD) meta-analysis of mother-offspring pairs from prospective birth cohort studies that had IPD on mothers with singleton liveborn children born from 1989 onwards and had information available about maternal gestational diabetes, gestational hypertension or pre-eclampsia, and childhood body-mass index (BMI). We applied multilevel mixed-effects models to assess associations of gestational diabetes, gestational hypertension, and pre-eclampsia with BMI SD scores and the odds of overweight and obesity throughout childhood, adjusting for lifestyle characteristics (offspring's sex, maternal age, educational level, ethnicity, parity, and smoking during pregnancy). We then explored the extent to which any association was explained by maternal pre-pregnancy or early-pregnancy BMI.\n\n\nFINDINGS\n160 757 mother-offspring pairs from 34 European or North American cohorts were analysed. Compared with uncomplicated pregnancies, gestational diabetes was associated with increased odds of overweight or obesity throughout childhood (odds ratio [OR] 1·59 [95% CI 1·36 to 1·86] for early childhood [age 2·0-4·9 years], 1·41 [1·26 to 1·57] for mid childhood [5·0-9·9 years], and 1·32 [0·97 to 1·78] for late childhood [10·0-17·9 years]); however, these associations attenuated towards the null following adjustment for maternal BMI (OR 1·35 [95% CI 1·15 to 1·58] for early childhood, 1·12 [1·00 to 1·25] for mid childhood, and 0·96 [0·71 to 1·31] for late childhood). Likewise, gestational hypertension was associated with increased odds of overweight throughout childhood (OR 1·19 [95% CI 1·01 to 1·39] for early childhood, 1·23 [1·15 to 1·32] for mid childhood, and 1·49 [1·30 to 1·70] for late childhood), but additional adjustment for maternal BMI largely explained these associations (1·01 [95% CI 0·86 to 1·19] for early childhood, 1·02 [0·95 to 1·10] for mid childhood, and 1·18 [1·03 to 1·36] for late childhood). Pre-eclampsia was associated with decreased BMI in early childhood only (difference in BMI SD score -0·05 SD score [95% CI -0·09 to -0·01]), and this association strengthened following additional adjustment for maternal BMI.\n\n\nINTERPRETATION\nAlthough lowering maternal risk of gestational diabetes, gestational hypertension, and pre-eclampsia is important in relation to maternal and fetal pregnancy outcomes, such interventions are unlikely to have a direct impact on childhood obesity. Preventive strategies for reducing childhood obesity should focus on maternal BMI rather than on pregnancy complications.\n\n\nFUNDING\nEU's Horizon 2020 research and innovation programme (LifeCycle Project).","claims":[{"public_id":"cl_ca6ff597c8ec663ea1d4d88fd7c82df2","status":"active","text":"Gestational diabetes is associated with increased odds of overweight or obesity throughout childhood, but the association is attenuated after adjustment for maternal BMI.","confidence":0.98,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_ca6ff597c8ec663ea1d4d88fd7c82df2"},{"public_id":"cl_da1f1121f19c457fed1b6b99887371f6","status":"active","text":"Gestational hypertension is associated with increased odds of overweight throughout childhood, and maternal BMI largely explains this association.","confidence":0.98,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_da1f1121f19c457fed1b6b99887371f6"},{"public_id":"cl_1fb7c8dbe0da816ddd7471db24a0a938","status":"active","text":"Pre-eclampsia is associated with decreased BMI in early childhood only, and the association strengthens after adjustment for maternal BMI.","confidence":0.93,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_1fb7c8dbe0da816ddd7471db24a0a938"},{"public_id":"cl_4aab711a29b0600e70de7e504ee657f2","status":"active","text":"Preventive strategies for reducing childhood obesity should focus on maternal BMI rather than on pregnancy complications.","confidence":0.91,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_4aab711a29b0600e70de7e504ee657f2"}],"concepts":[{"public_id":"co_13cd530270d9850d9f29c188ac119136","status":"active","name":"BMI in early childhood","description":"Body-mass index measured in the early childhood age range.","types":["outcome"],"aliases":["early childhood BMI"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_13cd530270d9850d9f29c188ac119136"},{"public_id":"co_1835a4942fb26a08dd3ab80fc21add27","status":"active","name":"childhood obesity","description":"Obesity occurring during childhood or adolescence.","types":["outcome"],"aliases":[],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_1835a4942fb26a08dd3ab80fc21add27"},{"public_id":"co_40fb7aed3c90a7db4d5c22f58d0e5da8","status":"active","name":"overweight throughout childhood","description":"Childhood weight status characterized by overweight across childhood age periods.","types":["outcome"],"aliases":["childhood overweight"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_40fb7aed3c90a7db4d5c22f58d0e5da8"},{"public_id":"co_6ae04e3fa912517f72438650d4b6cc68","status":"active","name":"maternal BMI","description":"The mother's body mass index measured before pregnancy or in early pregnancy.","types":["exposure","covariate"],"aliases":["maternal body-mass index"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_6ae04e3fa912517f72438650d4b6cc68"},{"public_id":"co_80cf9f1825f20f720fc4eb7ab34a906b","status":"active","name":"overweight or obesity throughout childhood","description":"Childhood weight status defined as being overweight or obese across childhood age periods.","types":["outcome"],"aliases":["childhood overweight or obesity"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_80cf9f1825f20f720fc4eb7ab34a906b"},{"public_id":"co_9293b292222ae1548821a219c7b4d444","status":"active","name":"pregnancy complications","description":"Adverse conditions occurring during pregnancy, including gestational diabetes, gestational hypertension, and pre-eclampsia.","types":["clinical category"],"aliases":[],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_9293b292222ae1548821a219c7b4d444"},{"public_id":"co_aa08cfc5069f29160546355c455b7a36","status":"active","name":"gestational diabetes","description":"Diabetes first recognized during pregnancy.","types":["pregnancy complication"],"aliases":["GDM"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_aa08cfc5069f29160546355c455b7a36"},{"public_id":"co_bbe9a46ca855d7fec80a53a67ec95ab6","status":"active","name":"pre-eclampsia","description":"A pregnancy disorder characterized by hypertension and signs of organ dysfunction, 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